Why do my teeth hurt when I bite down?

Tooth pain when biting down is a common symptom that many people suffer from without any visible issue. Such discomfort creates concern and makes patients search for the underlying cause; is it related to the tooth itself, its pulp, restorations, or other factors?

Here, we will answer a confusing question: Why do my teeth hurt when I bite down?. And explore the common causes and outline the available treatment options. 

Tooth Pain and Sensitivity

You could have some warning signs that need dental intervention. You may feel severe, sharp, and throbbing pain that doesn’t ease after chewing. 

This pressure can irritate the sensitive dentin layer of teeth, resulting in tooth sensitivity. That is usually increased by consuming hot, cold, or spicy foods and drinks. 

Causes of Tooth Pain When Biting Down

In some cases, tooth pain when biting is clearly caused by a specific defect; in others, the cause may be less obvious. Below are the most common causes:

Tooth-related causes 

• Tooth caries
  It is one of the most common causes of tooth pain when biting. With improper oral hygiene care,  bacteria produce acids that destroy the enamel layer, making a hole in the teeth. 
• Tooth sensitivity
  When a healthy tooth loses its outer protection layer (enamel or cementum). An underlying dentin becomes exposed, leading to pain and discomfort on biting hot or cold food. 
• Cracked tooth
  If the tooth has any cracks, this means a small gap in the enamel surface that allows any stimulator to reach deeper inside the tooth structure, causing severe pain. 
• Teeth wear
  Excessive tooth wear from bruxism or aging causes dentin exposure leads to tooth sensitivity. 
• Dental abscess
  An untreated cavity or failed root canal treatment allows bacteria to escape beyond the pulp to the periodontal ligaments and bone. It leads to inflammation, swelling, and pain on biting.
• Defective restoration and crown
  Poorly fitted restorations or crowns allow bacterial leakage or create high points, resulting in severe pain that increases with biting 
• Malocclusion
  It refers to the improper alignment between upper and lower teeth. It can be congenital or caused by local dental or joint factors, such as teeth crowding or missing teeth. 
• Impacted wisdom tooth 
  An impacted third molar can cause gum inflammation and pericoronitis, food impaction, and decay, resulting in severe pain during chewing.

Para dental causes

Surprisingly, not only are dental issues the main cause, but also other non-dental factors. Including: 

• Sinus infection: an infected maxillary sinus may affect the neighbouring teeth, as it is close to the upper back teeth.
• TMJ disorders: any jaw joint defects can affect the bite relationship and cause discomfort, a clicking sound, and pain during biting. 
• Gum disease: an infected gum can cause swelling and pain on pressure. 

At-home Remedy to stop teeth pain on pressure 

It is important to know how to deal with your pain at home for more comfort. There are some ways you should stick to, including:

1. Use OTC medications such as paracetamol or ibuprofen.
2. Avoid any irritants: Such as hot, cold, hard, citrus food and drinks. 
3. Rinse with warm salt water, which can reduce gum inflammation. 
4. Use a cold compress if you have a tooth injury or swelling. It should apply to the external side of the cheek.
5. Elevate your head when sleeping, especially if your pain increases when lying down, such as with sinus infections.
6. Use desensitizing fluoride-containing toothpaste to block the tooth nerves and decrease the pain sensation 

Maintaining good oral hygiene is the key to preventing the condition from worsening. 

When to Immediately See a Dentist?

Dental pain with specific characteristic features often warrants immediate professional evaluation, including:

• Persistent pain that doesn’t resolve with pain relievers.
• Pain that becomes more intense over time.
• Extreme pain with biting, or when consuming hot, cold, or crunchy foods
• Tooth injury or trauma
• If pain is accompanied by redness, gum swelling, bleeding, fever, or bad taste. 

How do we diagnose tooth pain on biting
At Suave Clinic?

At Suave Dental Clinic, we believe that an accurate diagnosis is the cornerstone for effective treatment. Through a systematic diagnostic process, which includes the following steps:

• Taking history
  We begin by collecting relevant medical and dental history. This may affect the treatment pathway. We also consider the patient’s chief complaint and his expectations of treatment outcomes, which helps us deliver more reliable results.
• Physical diagnosis
  A comprehensive examination of teeth, gums, bite assessment, and Temporomandibular joints is performed using manual palpation and a periodontal probe.
• Imaging diagnosis
  For a more accurate outcome, additional imaging may be required, such as a dental x-ray, like panoramic x-rays, bite wing X-ray, or a more advanced type like cone beam CT to see beyond what is visible clinically and confirm the initial diagnosis. 

Based on these diagnostic processes, we develop a customised treatment plan with a clear timeline. 

What are the Treatment Options? 

Treatment options depend on identifying the cause of pain when biting down. Here are various options to stop further damage to teeth: 

1. Tooth sensitivity treatment 
   Treatment ranges from using desensitizing toothpaste to professional fluoride application or dental crowns when needed. 
2. Decayed tooth treatment
   Tooth Cavities are treated with a dental filling to return the tooth to its ideal condition, such as composite bonding or indirectly with dental inlay or onlay ceramic restoration.
3. Abscessed tooth treatment
   Treatments depend on the source of infection. For example, Pulp infection is treated with root canal treatment, while Periodontal tissue infection, like periodontitis, is managed with scaling, root planning, and pocket treatment.
   In worst cases, when there is a noticeable swelling, drainage, or when the infection is severe, surgical removal of the infected root tip may be required. Extraction is considered only when the tooth is totally nonrestorable.
4. Cracked teeth treatment can be
   • A dental crown is made from different materials, like PFM, all-ceramic, or zirconia material, to protect the tooth. 
   • A dental veneer, which is a tooth-colored shell, covers the front surface of teeth to mask mild cracks. Available in different materials like composite, porcelain, or Lumineers. 
5. Vertical tooth fracture can cause severe damage to the tooth structure, resulting in tooth extraction.
6. Severe Malocclusion Treatment 
   It can be corrected with traditional metal braces or lingual orthodontics. 
7. High point dental filling and hyperocclusion 
   Poorly fitted restorations or prostheses need to be replaced with a new one. Ensuring proper fit, sealed margin, and proper occlusion without any high point. 
8. Impacted third molar treatment
   If the third molar is partially impacted, wisdom tooth removal is the suitable treatment for absolute cause removal. 
9. Treatment of TMJ disorders 
   It depends on the severity of symptoms. This includes bite adjustment, night guard, joint injection, and other treatment options. 
10. Gum disease treatment 
    They are treated differently according to severity. Often, start with improving oral hygiene and scaling with gingivectomy, cosmetic gum surgery, or root planning in advanced cases.

Tooth pain when biting down should never be ignored. At-home Remedies can temporarily ease the pain, but don’t eliminate it. At Suave Dental Clinic, we carefully assess each case to identify the root cause, providing a customized treatment to maintain healthy teeth.